<!--Bootstrap modal: Edit-->

<div class="modal-content">
	<div class="modal-header">
		<h4 class="modal-title" id="mdtitle">ADD ACCOUNT</h4>
		<div class="alert alert-danger" role="alert"  id="sentErr" style="font-family: cursive;font-size: 18px;"></div>
	</div>
	<div class="modal-body">
		<form class="form-horizontal" name="myForm" onsubmit="return validate();" action="" method="GET">

			<table id="example" class="table table-reponse" cellspacing="0" width="100%">
				<tr>
					<td><label>Account Number</label></td>
					<td><input type="text" class="control-label"
						id="accountNumberAdd" name="accountNumberAdd"></td>
					<td>&nbsp;</td>
					<td><label>Identity Card</label></td>
					<td><input type="text" class="control-label"
						id="identityCardAdd" name="identityCardEdit"></td>
				</tr>
				<tr>
					<td><label>First Name</label></td>
					<td><input type="text" class="control-label"
						id="firstNameAdd" name="firstNameEdit"></td>
					<td>&nbsp;</td>
					<td><label>Middle Name</label></td>
					<td><input type="text" class="control-label" id="midNameAdd"
						name="midNameEdit"></td>
				</tr>
				<tr>
					<td><label>Last Name</label></td>
					<td><input type="text" class="control-label" id="lastNameAdd"
						name="lastNameEdit"></td>
					<td>&nbsp;</td>
					<td><label>Phone 1</label></td>
					<td><input type="text" class="control-label" id="phone1Add"
						name="phone1Edit"></td>
				</tr>
				<tr>
					<td><label>Phone 2</label></td>
					<td><input type="text" class="control-label" id="phone2Add"
						name="phone2Edit"></td>
					<td>&nbsp;</td>
					<td><label>Email 1</label></td>
					<td><input type="text" class="control-label" id="email1Add"
						name="email1Edit"></td>
				</tr>
				<tr>
					<td><label>Email 2</label></td>
					<td><input type="text" class="control-label" id="email2Add"
						name="email2Edit"></td>
					<td colspan="3" style="text-align: center; margin-left: 10px">
						<input type="button" class="btn btn-primary" onclick="validate()" value="OK" />
						<input style="margin: 0px 20px" type="reset" class="btn btn-primary"  value="Reset" />
						<input type="button" class="btn btn-primary" onclick="cancelAccount()" value="Cancel" />
					</td>
				</tr>
			</table>

		</form>
	</div>
	<div class="modal-footer"></div>
</div>
